Staff-to-service-user ratios ‘not safe’ in UK social work, say two-thirds of practitioners

The ratio between the numbers of staff and the people they support is not safe in UK social work services, say two-thirds of practitioners.

Social workers are also working increasing amounts of overtime and facing rising levels of burnout on the back of the pandemic, while over a third have considered leaving the profession.

Those were among the findings of the sixth wave of research into Covid-19’s impact on health and social care practitioners, which started in May 2020 and has been carried out by academics from Ulster University, Queen’s University Belfast, Bath Spa University and University College London.

In a report on the impact on social work across the six phases  with a focus on the latest, conducted from November 2022 to January 2023, researchers found a picture of worsening pressures and workplace wellbeing.

‘Unsafe’ staffing levels

For the first time, in phase six of the health and social care (HSC) workforce study, the research team asked practitioners whether they believed their service operated a safe staff-to-service user ratio.

Among social workers, 64.7% said no, higher that the 56.4% recorded across the whole sample, which included social care workers, nurses, midwives and allied health professionals.

The proportion of social workers feeling staffing ratios were not safe was highest in England (69.7%), with Northern Ireland (66.5%) having the next highest rate. Of the 406 social worker respondents to phase six, 174 were from Northern Ireland, 104 from England, 68 from Scotland and 60 from Wales.

Social workers were also working more overtime than at the start of the pandemic. Overall, 78.8% worked some overtime, compared with 69.9% at phase two (surveyed November 2020 to February 2021), while 44.4% did at least five hours’ overtime a week at phase six, compared with 34.3% at phase two.

Reflecting this, over three in five social workers (61.2%) responding to the phase six survey said they felt “overwhelmed by increased and continued pressures”.

Record burnout rates

Also, burnout levels for social workers – defined as a “state of prolonged physical and psychological exhaustion” and measured by the 19-point Copenhagen Burnout Inventory – also reached their highest levels since the survey began.

Personal burnout was measured as 64.62, compared with 60.76 at phase two, burnout perceived as related to work was 62.79 (phase two: 58.38) and burnout perceived as related to work with clients was 34.74 (phase two: 30.19).

Respondents who felt overwhelmed by increased pressures and those who felt staffing ratios were not safe reported significantly more of all three types of burnout than those who felt otherwise.

Social workers’ wellbeing, measured using the Short Warwick Edinburgh Mental Wellbeing Scale, had remained relatively consistent UK-wide since phase two of the report, at around 20.3, with scores of 18-20 constituting possible cases of depression or anxiety.

The authors said that this showed that “wellbeing has not improved, even as the population begins to move beyond the pandemic era”.

As with burnout, wellbeing scores were significantly lower among those who felt overwhelmed and that staffing levels were not safe, while staff in England had lower scores (19.57 on average) than those in the other Northern Ireland (20.56), Scotland (20.44) and Wales (20.91).

Decline in quality of life at work

Social workers’ quality of working life had also declined, as measured by the Work-Related Quality of Life (WRQOL) scale, the phase six survey found. This asks participants to what extent they agree with a series of work-related statements on career satisfaction, stress at work, general wellbeing, home-work interface, control at work and working conditions.

The average WRQOL score for social workers had fallen from 71.75 to 71.11 between phases five and six, the lowest score with the exception of phase four (70.82).

The phase six survey also found that 36.2% of social workers had considered changing their occupation, with the highest proportion being from England (44.2%), followed by Northern Ireland (36.2%), Scotland (32.4%), and Wales (26.7%).

The findings come with unions representing social workers taking industrial action in Northern Ireland on the issue of safe staffing. The Northern Ireland Public Services Alliance (NIPSA), which represents most of the province’s social workers, and UNISON have been taking action short of a strike on the issue, including not doing unpaid overtime, on the issue since November.

Social workers ‘dealing with crisis after crisis’

In an interview last month with Community Care, Damien Maguire, NIPSA’s branch chair at Belfast Health and Social Care Trust, said demand and staffing pressures had led to many social workers working overtime, driving some to burnout.

“We have to have a situation where caseloads are safe in order to draw people into the service and retain the staff that you have,” he said. “If you don’t retain, and you can’t recruit you are going down a plughole of service collapse.”

He added: “What we need to give social workers are the tools they need to do proper social work. So many social workers say to me that they don’t feel like social workers, they just deal with crisis after crisis after crisis.”

In response to phase six of the HSC study, Carolyn Ewart, national director of the British Association of Social Workers Northern Ireland (BASW NI), said: “Given the extent of the pressure facing social workers in Northern Ireland, BASW NI is unsurprised, yet deeply concerned at the findings of this research. Change is needed and we are working with the Department of Health to influence the development of safe staffing legislation which will help protect staff and service users by ensuring no social workers carry unmanageable caseloads.

“At 11.2%, social work now has a higher rate of vacant posts than all of our healthcare colleagues. The department must prioritise the recruitment and retention of staff by addressing the workplace stresses and challenges which are leading to unsustainable levels of burnout.”